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PPACA Compliance Reporting 101

Posted on January 20th, 2016 Read time: 2 minutes

Ensuring accurate information reporting for compliance with the Patient Protection and Affordable Care Act (PPACA) can be very complex. Learn more about reporting requirements so your company avoids heavy fines and penalties for noncompliance.

  • Section 6055

Who must report and to whom?

Section 6055 applies to plan sponsors who issue minimum essential coverage and any self-insured company considered an “Applicable Large Employer.” Each employer must file information statements to the IRS and provide statements to each person enrolled in the plan during the calendar year.

What must be reported?

The Employer Identification Number, name, and address of plan sponsor; Taxpayer Identification Number for each person covered by “Minimum Essential Coverage” ; all months each full-time employee is enrolled in “minimum essential coverage” and is entitled to receive benefits for at least one day in such month must be reported. Covered individuals must be given the name, address, and contact number for the person required to file the returns.

When must this information be reported?

Electronically filed returns must be sent before April 1. Paper filed returns must be postmarked before March 1. Providing information statements to employees/covered individuals is due by January 31.

How must this information be reported?

For employers/self-insured plan sponsors, forms 1094-C and 1095-C will be used for filing.  For other plan sponsors, forms 1094-B and 1095-B will be used. Anyone who has to file 250 or more individual returns other than transmittal forms must do so electronically. The plan sponsor must also provide the information to each enrolled member through the mail or, with written permission, electronically.

Section 6056

Who must report and to whom?

Section 6056 applies to “Applicable Large Employers” (ALE) who averaged at least 50 full-time employees during the previous calendar year and “ALE Members” of an aggregated group determined to be an ALE. Employers may use third-party agents and service providers, such as Innovative Employee Solutions, to gather the necessary information, provide the reporting, and respond to resulting inquiries from employees or the IRS.

What must be reported?

Due to the complexities involved, refer to IRS Reporting Compliance under Sections 6055 and 6056.

When must this information be reported?

Section 6056 deadlines are the same as Section 6055 deadlines noted above.

How must this information be reported?

Applicable Large Employers, ALE members, and self-insured employers must file forms 1094-C and 1095-C. Any company filing at least 250 Section 1095-C returns, not counting transmittal forms, must file electronically. A copy of the 1095-C will be sent to the full-time employee by mail or, with written permission, electronically.

Failure to file or provide statements to employees

The failure to file or failure to provide statements penalty is $100 per return, not to exceed $1.5 million annually. Intentionally disregarding the obligations can result in additional penalties.

You can’t afford to let your company be noncompliant with the PPACA. To take care of all your compliance needs, contact Innovative Employee Solutions today!

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